Early clinical predictors of intractable epilepsy in childhood

Saygı, Semra; Erol, İlknur; Alehan, Füsun

doi:10.3906/sag-1302-4

Cited by 11 publications

(9 citation statements)

References 13 publications

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“…Like our study, in most studies, initial seizure frequency was identified as a risk factor for drug resistance [7,8,10,11]. Repeated seizures have been shown to produce neuronal loss and mossy fiber sprouting in the hippocampus, which may cause the forming of excitatory recurrent circuits [12].…”

Section: Discussionsupporting

confidence: 58%

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Clinical predictors of drug-resistant epilepsy in children

Karaoğlu¹,

Yış²,

Polat³

et al. 2021

Turk J Med Sci

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Background/Aim: In up to 20% of epilepsy patients, seizures may not be controlled despite the use of antiepileptic drugs, either singly or in combination. These individuals are considered to have drug resistant epilepsy. Drug resistant epilepsy is usually associated with intellectual disability, psychiatric comorbidity, physical injury, sudden unexpected death, and low life quality. Early detection and prediction of drug resistant epilepsy is essential in determining the patient's most appropriate treatment option. This retrospective study aimed to determine the clinical, electroencephalographic, and radiological factors associated with medically intractable childhood seizures.Materials and methods: Data regarding 177 patients diagnosed with drug resistant epilepsy were compared with 281 patients with drug responsive epilepsy.Results: Univariate analysis showed that age at seizure onset, having mixed seizure types, history of status epilepticus, history of neonatal seizures, history of both having febrile and afebrile seizures, daily seizures at the onset, abnormality on the first electroencephalogram, generalized epileptic abnormality on electroencephalogram, abnormal neurodevelopmental status, abnormal neuroimaging, having symptomatic etiology were significant risk factors for the development of drug resistant epilepsy (P < 0.05). In multivariable analysis, having mixed seizure types, history of status epilepticus, having multiple seizures in a day, intellectual disability, symptomatic etiology, and neuroimaging abnormality remained significant predictors for developing drug resistant epilepsy. Conclusions:In the course of childhood epilepsy, some clinical features may predict the outcome. Early identification of patients with high risk for drug resistant epilepsy will 2 help plan the appropriate treatment option. Further prospective studies should confirm these findings.

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Section: Discussionsupporting

confidence: 58%

“…In most previous studies, symptomatic etiology has been reported as a significant risk factor for drug-resistant epilepsy [1,8,11,13]. The changed structure of the central nervous system and function leads to hyperexcitability as the cause of epilepsy.…”

Section: Discussionmentioning

confidence: 99%

Clinical predictors of drug-resistant epilepsy in children

Karaoğlu¹,

Yış²,

Polat³

et al. 2021

Turk J Med Sci

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“…The 16 studies included 9 prospective analyses [20–22,25–30] and 7 retrospective analyses. [23,24,31–35]…”

Section: Resultsmentioning

confidence: 99%

“…[21,26,28] Nevertheless, 4 authors defined more than 10 seizures as a high initial seizure frequency, and their pooled results also contributed to the development of drug resistance. [20,24,30,31] Repeated seizures have been shown to produce neuronal loss and mossy fiber sprouting in the hippocampus, which in turn can reinforce their production, forming excitatory recurrent circuits. [52,53] Seven studies clearly showed that EEG abnormality was a predictor for intractability, [23,25,28,32,33,35] and 3 of them clarified that the EEG abnormality was a slow wave and 4 of that were epileptiform discharges.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for drug-resistant epilepsy

Wang

Wang²,

Zhu³

et al. 2019

Medicine

108

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“…One of the notable risk factors is age at onset of seizures. In many studies based on age at onset of the first seizure, the ratios of seizure in the first year of life ranged from 50% to 60% in intractable epilepsy patients and from 10% to 20% in drug-responsive epilepsy patients, and this was reported as a risk factor (6)(7)(8). It is known that the onset of seizures within the first year of life facilitates the epileptogenic tendency during the development of the immature brain (9).…”

Section: Discussionmentioning

confidence: 99%

Six Clinical Predictors for Intractable Childhood Epilepsy

Ayça¹,

Oral²,

Dündar³

et al. 2019

jpr

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This study aimed to determine the significance of six clinical predictors associated with medically intractable childhood epilepsy. Materials and Methods: A retrospective cohort study was conducted. A total of 241 children with diagnosed epilepsy were recruited and divided into two groups: 61 patients with intractable epilepsy, and the other 180 patients who responded well to antiepileptic drugs. We investigated seizure semiology, etiology of epileptic encephalopathy, EEG abnormalities and defined the odds ratios (ORs) of predictor factors for intractable childhood epilepsy; age of seizure onset, asphyxia, neonatal intensive care unit (NICU) history, consanguineous marriage, abnormal neuro-imaging, neuropathologic exam, prematurity, parents' seizure history. Results: According to logistic regression analysis, the major risk factors for intractable childhood epilepsy are (1) neuropathologic examination p=0.

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Early clinical predictors of intractable epilepsy in childhood

Cited by 11 publications

References 13 publications

Clinical predictors of drug-resistant epilepsy in children

Clinical predictors of drug-resistant epilepsy in children

Risk factors for drug-resistant epilepsy

Six Clinical Predictors for Intractable Childhood Epilepsy

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